Liquid biopsy of circulating tumor cells: From isolation, enrichment, and genome sequencing to clinical applications

Keqin Tan ¹, Hong Zhu ², Xuelei Ma ³

⁰Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.

Histology and Histopathology +

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May 7, 2025

View abstract on PubMed

Summary

Circulating tumor cells (CTCs) are key to cancer spread. New methods improve CTC isolation and analysis, aiding cancer diagnosis, prognosis, and personalized treatment strategies.

Area Of Science

Oncology
Biotechnology
Molecular Biology

Background

Circulating tumor cells (CTCs) are vital indicators of cancer metastasis.
Traditional methods using epithelial biomarkers (e.g., EpCAM) miss mesenchymal CTCs with high metastatic potential.
There is a need for advanced CTC isolation and analysis techniques.

Purpose Of The Study

To review advancements in CTC isolation and enrichment technologies.
To explore the applications of CTCs in various cancer types.
To discuss the progress in downstream CTC analysis and their role in precision medicine.

Main Methods

Review of microfluidic platforms and biophysical trait-based enrichment methods.
Analysis of single-cell genomic and transcriptomic sequencing for CTC characterization.
Examination of clinical applications of CTC enumeration and molecular profiling.

Main Results

Non-immunocapture technologies effectively isolate mesenchymal-like CTCs.
Microfluidic platforms and multi-parametric sorting enhance CTC isolation efficiency.
CTC enumeration and profiling show promise as real-time tools for treatment monitoring.

Conclusions

Advanced CTC isolation techniques overcome limitations of traditional methods.
Single-cell analysis provides deep molecular insights into CTCs.
CTCs are emerging as critical tools for precision oncology, particularly in metastatic cancers.